Pubdate: Thu, 03 Apr 2014
Source: Missoula Independent (MT)
Copyright: 2014 Missoula Independent
Author: Jessica Mayrer
Bookmark: (Needle Exchange)


Behind the Scenes of the State's First Open Needle

On a recent afternoon, a dark-haired woman picks out several syringes
from a selection of injection drug paraphernalia setup in a downtown
Missoula hallway. The state's first aboveground needle exchange
includes everything from tourniquets to antiseptic wipes to tins known
as "cookers."

At first glance, the woman doesn't look like anyone portrayed in the
Montana Meth Project's jolting "Not Even Once" anti-drug ad campaign.
She's not emaciated. Her clothes aren't dirty. She says she takes care
of herself, eating and sleeping regularly.

"I'm hungry," she says sarcastically.

Upon closer inspection, however, subtle details betray her drug habit.
A small line of needle marks are exposed on her right hand. She agrees
to talk to a reporter, but only if granted anonymity for fear that she
could be criminally prosecuted for speaking candidly about her drug
use. We'll call her Shannon.

Shannon says she is a 43-year-old grandmother who first used IV drugs
26 years ago. While she's had clean stretches, she admits that these
days she can't get out of bed without a fix. "It's a necessity after a
while," she says. "I don't think I'll ever quit."

Before learning about the Missoula needle exchange, hosted by the
nonprofit Open Aid Alliance, Shannon had an increasingly difficult
time scoring sterile syringes. Old syringes are susceptible to
bacteria buildup and can lead to dangerous infections.

"It's tougher and tougher," she says. "And the stigma just gets larger
and larger."

It's legal to sell syringes without a prescription in Montana.
Pharmacists, however, use discretion when distributing them. When
Shannon's regular provider abruptly stopped selling her needles, she
remembers thinking to herself, "So, I'll go find one in the garbage?"

Once Shannon resorted to using old syringes, she says that she
developed a painful vein abscess-one that was potentially life
threatening. "I have vascular damage now," she says. "It is so
devastating what can happen in a short amount of time."

Facing mounting health problems, Shannon was relieved to find the Open
Aid Alliance's new Syringe Exchange Program. Since launching the
program less than a year ago, staff say they have distributed
approximately 25,000 needles to area drug users.

"We started very slowly, kind of just tipping our toes in the water,"
says Open Aid Alliance Prevention and Harm Reduction Specialist
Stephanie Cole. "And then it blew up."

Clients include the young and old, affluent and poor. Though they're
not required to disclose names, exchange clients are asked to detail
their drug histories, including which drugs they've used, whether
they've ever overdosed and if they know their hepatitis and HIV
status. The intake form also asks whether the client would like to be
tested for the viruses.

Social workers call the principle behind needle exchanges "harm
reduction." The idea is to reduce the human and financial fallout
associated with drug use, while linking clients to social services, if
they desire help.

Bacterial infection like what Shannon developed constitutes just one
problem associated with IV drug use. In Montana, the Department of
Public Health and Human Services estimates 12 percent of the 652 HIV
cases reported statewide between 1985 and 2012 stemmed from injection

The Centers for Disease Control and Prevention peg the lifetime cost
of treating an HIV infection at $379,668. Nationally, the
taxpayer-funded expenses associated with medicating and housing people
infected with the virus, according to the Henry J. Kaiser Foundation,
will top $19 billion this year.

Open Aid Alliance Executive Director Christa Weathers notes that it
doesn't take much number crunching to realize the economic benefits of
needle exchanges. For $800 a month, the Open Aid Alliance can
distribute 4,000 syringes and other paraphernalia to help stop the
spread of disease.

"It's crazy that this is the first visible syringe exchange in
Montana," Weathers says.

Despite her incredulity, Weathers knows from firsthand experience that
state and federal policies make launching a needle exchange anything
but easy. Among the biggest barriers is funding. The U.S. Congress has
for decades banned using federal dollars for needle exchanges, based
on the argument that providing paraphernalia encourages drug use and,
in doing so, fuels crime and disease.

Science doesn't reinforce that argument. The Office of the Surgeon
General, CDC and National Academy of Sciences have found needle
exchanges a cost-effective way of curbing infection, without increased
drug use.

Locally, the Open Aid Alliance has overcome funding challenges with
help from the Llewellyn and Wagon Mountain foundations and the United
Way of Missoula County.

The second hurdle comes from state law. Montana statute criminalizes
possession of syringes with even a trace amount of drug residue. That
deters people from returning used needles, Weathers says. "People just
don't want to bring them in," she says.

In response to concerns about returning needles to the exchange,
Missoula Police Department Public Information Officer Travis Welsh
says though MPD doesn't condone illegal drug use, city law enforcement
has no intention of targeting the Open Aid Alliance. "It's much better
that people have a place to dispose of these needles safely," Welsh
says. "From the holistic community perspective, it makes a lot of sense."  
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